Question

A child presents with abdominal pain only during passage of stools. There are no other symptoms like vomiting or blood in stools, and there are no signs of intestinal obstruction. The most probable diagnosis is?

• A. Rectal polyp
• B. Intussusception
• C. Meckel's diverticulum
• D. Necrotising enterocolitis

Hint:

Pain only while passing stool, otherwise well, in a child points to a low rectal lesion.

Answer 1

The Correct Option is A

The discriminating clue is that the only complaint is pain that appears specifically while the child is passing stool, with no vomiting, no bleeding and no obstruction. A symptom tied so tightly to the act of defecation suggests a lesion sitting low in the rectum that gets squeezed and irritated as stool passes.

A juvenile rectal polyp matches this perfectly, as it is the most frequent rectal growth in children and produces exactly this kind of defecation-related discomfort.

The alternatives can be reasoned away. Intussusception is a triad of colicky pain, vomiting and currant-jelly stools with a palpable sausage-shaped mass, so the absence of vomiting and bleeding argues against it. A Meckel diverticulum typically announces itself with painless bleeding per rectum rather than pain on defecation. Necrotising enterocolitis is a sick neonate with distension and bloody stools, not a well child with isolated pain while stooling.

By elimination and by the defecation-linked pattern, the diagnosis is a rectal polyp.
\[\boxed{\text{Rectal polyp}}\]